Infection risks in multiple myeloma: a systematic review and meta-analysis of randomized trials from 2015 to 2019
Abstract Background Patients with multiple myeloma (MM) remain at an increased risk of infection due to the disease process, as well as the ensuing treatments. Methods We performed a systematic review to evaluate the monthly risk of grade III/IV infection, pneumonia, and neutropenia in patients with...
| Main Authors: | , , , , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
BMC
2021-06-01
|
| Series: | BMC Cancer |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12885-021-08451-x |
| _version_ | 1818743092580188160 |
|---|---|
| author | Nicole Balmaceda Muhammad Aziz Viveksandeep Thoguluva Chandrasekar Brian McClune Suman Kambhampati Leyla Shune Al-Ola Abdallah Faiz Anwer Aneela Majeed Muzaffar Qazilbash Siddhartha Ganguly Joseph McGuirk Ghulam Rehman Mohyuddin |
| author_facet | Nicole Balmaceda Muhammad Aziz Viveksandeep Thoguluva Chandrasekar Brian McClune Suman Kambhampati Leyla Shune Al-Ola Abdallah Faiz Anwer Aneela Majeed Muzaffar Qazilbash Siddhartha Ganguly Joseph McGuirk Ghulam Rehman Mohyuddin |
| author_sort | Nicole Balmaceda |
| collection | DOAJ |
| description | Abstract Background Patients with multiple myeloma (MM) remain at an increased risk of infection due to the disease process, as well as the ensuing treatments. Methods We performed a systematic review to evaluate the monthly risk of grade III/IV infection, pneumonia, and neutropenia in patients with myeloma enrolled in randomized clinical trials (RCTs). Results The risk of grade III or higher infection, pneumonia, and neutropenia persists among all phases of treatment. There was no statistical difference in grade III or higher infection, pneumonia, and neutropenia between frontline and relapsed/refractory setting. In the maintenance setting, the complications of infection, pneumonia, and neutropenia were low, but not negligible. Three-drug regimens were no more likely than two-drug regimens to have an increased risk of Grade III or higher infection. Conclusions This is the first study to quantify the monthly risk of grade III or higher infection, pneumonia, and neutropenia across different treatment regimens in the frontline, maintenance, and relapsed/refractory settings. The results of our systematic review demonstrate a significant risk for severe infection, pneumonia, and neutropenia in patients with MM. Further studies are needed to determine the value of antibiotic prophylaxis in a broader myeloma patient population, as well as other approaches that will further mitigate the morbidity and mortality related to infection in this vulnerable patient population. |
| first_indexed | 2024-12-18T02:22:55Z |
| format | Article |
| id | doaj.art-cb3bb2d95ce64ff995577383bb9c055e |
| institution | Directory Open Access Journal |
| issn | 1471-2407 |
| language | English |
| last_indexed | 2024-12-18T02:22:55Z |
| publishDate | 2021-06-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Cancer |
| spelling | doaj.art-cb3bb2d95ce64ff995577383bb9c055e2022-12-21T21:24:06ZengBMCBMC Cancer1471-24072021-06-0121111110.1186/s12885-021-08451-xInfection risks in multiple myeloma: a systematic review and meta-analysis of randomized trials from 2015 to 2019Nicole Balmaceda0Muhammad Aziz1Viveksandeep Thoguluva Chandrasekar2Brian McClune3Suman Kambhampati4Leyla Shune5Al-Ola Abdallah6Faiz Anwer7Aneela Majeed8Muzaffar Qazilbash9Siddhartha Ganguly10Joseph McGuirk11Ghulam Rehman Mohyuddin12University of Kansas Cancer CenterUniversity of ToledoMayo Clinic ArizonaUniversity of UtahU.S. Department of Veterans Affairs, Kansas City Medical CenterUniversity of Kansas Cancer CenterUniversity of Kansas Cancer CenterCleveland ClinicCleveland ClinicUniversity of Texas MD Anderson Cancer CenterUniversity of Kansas Cancer CenterUniversity of Kansas Cancer CenterUniversity of Kansas Cancer CenterAbstract Background Patients with multiple myeloma (MM) remain at an increased risk of infection due to the disease process, as well as the ensuing treatments. Methods We performed a systematic review to evaluate the monthly risk of grade III/IV infection, pneumonia, and neutropenia in patients with myeloma enrolled in randomized clinical trials (RCTs). Results The risk of grade III or higher infection, pneumonia, and neutropenia persists among all phases of treatment. There was no statistical difference in grade III or higher infection, pneumonia, and neutropenia between frontline and relapsed/refractory setting. In the maintenance setting, the complications of infection, pneumonia, and neutropenia were low, but not negligible. Three-drug regimens were no more likely than two-drug regimens to have an increased risk of Grade III or higher infection. Conclusions This is the first study to quantify the monthly risk of grade III or higher infection, pneumonia, and neutropenia across different treatment regimens in the frontline, maintenance, and relapsed/refractory settings. The results of our systematic review demonstrate a significant risk for severe infection, pneumonia, and neutropenia in patients with MM. Further studies are needed to determine the value of antibiotic prophylaxis in a broader myeloma patient population, as well as other approaches that will further mitigate the morbidity and mortality related to infection in this vulnerable patient population.https://doi.org/10.1186/s12885-021-08451-xMultiple myelomaProteasome inhibitorsAnti-CD38Cytotoxic therapyInfection |
| spellingShingle | Nicole Balmaceda Muhammad Aziz Viveksandeep Thoguluva Chandrasekar Brian McClune Suman Kambhampati Leyla Shune Al-Ola Abdallah Faiz Anwer Aneela Majeed Muzaffar Qazilbash Siddhartha Ganguly Joseph McGuirk Ghulam Rehman Mohyuddin Infection risks in multiple myeloma: a systematic review and meta-analysis of randomized trials from 2015 to 2019 BMC Cancer Multiple myeloma Proteasome inhibitors Anti-CD38 Cytotoxic therapy Infection |
| title | Infection risks in multiple myeloma: a systematic review and meta-analysis of randomized trials from 2015 to 2019 |
| title_full | Infection risks in multiple myeloma: a systematic review and meta-analysis of randomized trials from 2015 to 2019 |
| title_fullStr | Infection risks in multiple myeloma: a systematic review and meta-analysis of randomized trials from 2015 to 2019 |
| title_full_unstemmed | Infection risks in multiple myeloma: a systematic review and meta-analysis of randomized trials from 2015 to 2019 |
| title_short | Infection risks in multiple myeloma: a systematic review and meta-analysis of randomized trials from 2015 to 2019 |
| title_sort | infection risks in multiple myeloma a systematic review and meta analysis of randomized trials from 2015 to 2019 |
| topic | Multiple myeloma Proteasome inhibitors Anti-CD38 Cytotoxic therapy Infection |
| url | https://doi.org/10.1186/s12885-021-08451-x |
| work_keys_str_mv | AT nicolebalmaceda infectionrisksinmultiplemyelomaasystematicreviewandmetaanalysisofrandomizedtrialsfrom2015to2019 AT muhammadaziz infectionrisksinmultiplemyelomaasystematicreviewandmetaanalysisofrandomizedtrialsfrom2015to2019 AT viveksandeepthoguluvachandrasekar infectionrisksinmultiplemyelomaasystematicreviewandmetaanalysisofrandomizedtrialsfrom2015to2019 AT brianmcclune infectionrisksinmultiplemyelomaasystematicreviewandmetaanalysisofrandomizedtrialsfrom2015to2019 AT sumankambhampati infectionrisksinmultiplemyelomaasystematicreviewandmetaanalysisofrandomizedtrialsfrom2015to2019 AT leylashune infectionrisksinmultiplemyelomaasystematicreviewandmetaanalysisofrandomizedtrialsfrom2015to2019 AT alolaabdallah infectionrisksinmultiplemyelomaasystematicreviewandmetaanalysisofrandomizedtrialsfrom2015to2019 AT faizanwer infectionrisksinmultiplemyelomaasystematicreviewandmetaanalysisofrandomizedtrialsfrom2015to2019 AT aneelamajeed infectionrisksinmultiplemyelomaasystematicreviewandmetaanalysisofrandomizedtrialsfrom2015to2019 AT muzaffarqazilbash infectionrisksinmultiplemyelomaasystematicreviewandmetaanalysisofrandomizedtrialsfrom2015to2019 AT siddharthaganguly infectionrisksinmultiplemyelomaasystematicreviewandmetaanalysisofrandomizedtrialsfrom2015to2019 AT josephmcguirk infectionrisksinmultiplemyelomaasystematicreviewandmetaanalysisofrandomizedtrialsfrom2015to2019 AT ghulamrehmanmohyuddin infectionrisksinmultiplemyelomaasystematicreviewandmetaanalysisofrandomizedtrialsfrom2015to2019 |